| 胡博,牛励,胡勇.股骨末端骨肿瘤外科治疗策略[J].济宁医学院学报,2019,42(5):356-359 |
| 股骨末端骨肿瘤外科治疗策略 |
| Surgical treatment strategy of bone tumors in the end of femur |
| 投稿时间：2019-09-03 |
| DOI：10.3969/j.issn.1000-9760.2019.05.011 |
| 中文关键词: 骨肿瘤;股骨末端;外科治疗;功能评分 |
| 英文关键词: Bone tumor;End of femur;Surgical treatment;Functional score |
| 基金项目:安徽省自然科学基金项目（1808085QH 245） |
| 作者 | 单位 | E-mail | | 胡博 | 安徽医科大学第一附属医院, 合肥 230022 | | | 牛励 | 安徽医科大学第一附属医院, 合肥 230022 | | | 胡勇 | 安徽医科大学第一附属医院, 合肥 230022 | hy.in163@163.com |
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| 中文摘要: |
| 目的 探讨股骨末端骨肿瘤外科手术治疗策略及其对术后功能恢复的影响。方法 选择62例在我院诊治的股骨末端病变患者进行回顾性分析。良性病变和低度恶性肿瘤采用刮除植骨内固定术；良性侵袭性肿瘤主要采取病灶刮除骨水泥填充或瘤段切除关节假体置换术；恶性肿瘤主要采取带血管腓骨复合大段异体骨移植术或关节假体置换术。术后根据国际保肢学会（ISOLS）功能标准进行评估。结果 所有患者均获得6~18个月随访。46例良性病变患者获得较好的功能恢复，其中良性病变2例复发，2例术后骨折。恶性肿瘤1例死亡，1例复发，9例无瘤存活。术后ISOLS功能评分：良性病变平均（24.73±6.58）分，恶性肿瘤平均（19.81±5.40）分，良恶性肿瘤术后功能评估无差异。结论 根据股骨末端病变的性质、范围选择个体化的手术方式，彻底清除病灶，减少局部复发，提高患者关节功能、改善预后。 |
| 英文摘要: |
| Objective To investigate the surgical treatment strategy of bone tumor in the end of femur and its effect on postoperative functional recovery.Methods 62 cases of bone tumors in the end of femur were retrospectively analyzed.Benign and low-grade malignant tumors were treated with curettage and bone grafting.Benign and invasive tumors were mainly treated by curettage,cement filling or segmental resection and prosthesis arthroplasty.Malignant tumors were mainly treated with vascularized fibula combined with large segment allograft or prosthesis arthroplasty.Postoperative scores were assessed according to the International Society for Limb Salvage(ISOLS) functional criteria.Results All patients were followed up for 6 to 18 months.46 patients with benign lesions achieved better functional recovery.Among them,2 cases of benign lesions recurred;2 cases of postoperative fractures;one patient died of malignant tumor;one patient relapsed;and nine patients survived without tumor.According to the ISOLS functional score,the average score of benign lesions was 24.73±6.58 and malignant tumors was 19.81±5.40.Conclusion According to the nature and scope of the femoral end lesions,individualized surgical methods are selected to completely eliminate the lesions,reduce local recurrence and improve joint function and improve prognosis. |
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